Non-sexual transmission of herpes
Herpes is passed on from person to person when the virus is shed from the skin of the first person and comes into contact with the skin of the second. This is what happens when a person first contracts cold sores or genital herpes. It’s sometimes possible for a person to transit the virus from one part of the body to another. This occasionally happens with herpetic whitlows, which are sores or blisters occurring on the fingers, or herpes keratitis, which affects the eyes.
If a person develops cold sores, genital herpes or other herpes-related symptoms, it means the virus has entered the body at or near that point. For example, someone with a cold sore could pass on the virus to another person’s lips by kissing him/her, or to the other person’s genitals by giving him/her oral sex.
Genital herpes is almost always transmitted through sex, and oral cold sores are almost always transmitted by kissing. These are obvious ways for direct skin-to-skin contact to allow the virus to “rub off” one person and on to another. But sometimes people with herpes or cold sores wonder if there are other ways of passing on the virus.
Why ask about non-sexual ways of transmitting herpes?
Most people with genital herpes assume they’ve caught it during sex. But there are many reasons why someone might wonder if herpes might be transmitted non-sexually. For example:
- They have herpes and don’t want to pass it on to contacts such as children or flatmates
- Someone in the household has herpes and they don’t want to contract it from this person
- They might have been diagnosed with herpes, and none of their sexual partners have ever had it
What influences the transmission of the herpes simplex virus?
Presence and amount of the virus
The herpes simplex virus can only be transmitted if someone is shedding it from their skin in the first place. The more virus, the easier it is to pass it on. There are more virus particles when a visible herpes outbreak is present, but from time to time a person can shed the virus from their skin with no obvious signs of herpes. This is called asymptomatic shedding and is the most common way of transmitting the virus. It can even occur when someone has never knowingly had an outbreak of herpes. Asymptomatic shedding causes most cases of herpes where the original source isn’t known.
The herpes simplex virus needs the correct humidity, temperature and chemical environment to survive outside the body. Laboratory experiments have shown that it is instantly killed on contact with spa or swimming pool water. It can survive for a few hours in tap water, or on a plastic object kept humid and at exactly the right temperature, but in the “real world”, these conditions are uncommon.
Even though the virus can survive outside the body in certain circumstances, it seems other conditions need to occur to allow transmission, making transmission from objects very unlikely.
The transmission site and type of contact
It appears that the herpes simplex virus can’t enter the body easily through intact skin. Areas where the skin is damaged or broken can more easily be infected.
Simply touching the virus probably isn’t likely to result in infection. It’s more likely to enter the body if it’s “rubbed in” to an area of skin that’s slightly damaged or abraded—this would happen during sex or kissing, but even the skin-to-skin contact of wrestling can transmit the virus sometimes, causing a condition known as herpes gladiatorum.
Non-sexual activities and transmission risks
| Activity | Risk | How and why? |
|---|---|---|
|
Wrestling with a cold sore present |
Moderate to high |
Because of the close, firm contact during wrestling, the virus could easily be rubbed directly from the lips of one wrestler to the face, shoulders, or arms of another. Wrestlers are usually prohibited from competing when they have active cold sores. |
|
Touching your own cold sore and then rubbing your eye |
Moderate |
The virus is carried from the finger immediately to the surface of the eye, which is easily damaged by rubbing. |
|
Touching your own cold sore and then touching other parts of your body |
Low to moderate |
The virus could be transmitted on a finger to another area of skin, but the risk is low because the other area would probably need to be damaged in some way and then rubbed very firmly with the finger. The finger itself could be infected if there’s a damaged area, for example at the cuticle. |
|
Sharing lipstick or lip gloss with someone who has a cold sore |
Low to moderate |
If the lipstick is shared immediately after the person with the cold sore has used it, the virus could possibly be rubbed into the other person’s lips. Note that the virus would probably not survive on the lipstick for more than an hour. |
|
Drinking from the same glass or sharing a fork or spoon as someone who has a cold sore |
Low |
The could theoretically survive on the glass or cutlery for a short period, but the risk of transmission is low because typically the glass or cutlery would not be firmly rubbed on to the second person’s lips. |
| Massage | Very low |
If the masseur has a herpes sore on his/her finger, there might be a small risk of rubbing it on to the other person. However, this would probably be uncomfortable for the masseur and therefore unlikely to occur. If the either the masseur or the person being massaged has genital herpes or cold sores and the massage is non-sexual, there is no risk of transmission. |
|
Sharing soap or a towel with someone who has genital herpes |
Very low |
If a person rubbed soap or a towel very firmly against their own genitals immediately after a person with active herpes sores had rubbed it against their own, there might be a small risk of transferring the virus. |
|
Sharing a toilet seat |
Virtually nil |
Although the herpes virus could theoretically survive on a toilet seat, it would need to be wet and the environment must be humid and between 37-40°—and then the person would need to firmly rub their skin against the seat. This combination of factors is very unlikely! |
|
Shaking hands |
Virtually nil |
A quick handshake would be unlikely to transmit the virus even if one person had herpes on their finger, as the affected area would not be in contact for long enough or firmly enough. There is no risk of contracting genital herpes from someone by shaking their hand |
|
Sharing underwear with someone who has genital herpes |
Virtually nil |
The virus would not survive well on underwear, and then would probably not rub firmly enough against the other person wearing the underwear. |
|
Sharing a bath, spa or swimming pool |
Virtually nil |
The virus is killed by the chlorine present in most spa and swimming pool water. Even in a bath of tap water, the virus would not rub firmly into the next person’s skin. |
| Re-using medical equipment (eg speculum used for Pap smear) |
Nil |
Medical equipment is always sterilised before it is re-used; the virus cannot survive this process. |
